Utah Poison Control Center Gets Bigger, Better as it Turns the Big Five-Oh

Utah Poison Control Center Gets Bigger, Better as it Turns the Big Five-Oh

Oct 26, 2004 6:00 PM

Syrup of Ipecac was the standard remedy for treating home poisonings when the Utah Poison Control Center (UPCC) was founded 50 years and more than 1 million phone calls ago.

Mercury thermometers, which for decades had reliably told physicians and parents whether their patients or children had a fever, were found in just about every U.S. household and doctor's office.

Bioterrorism was not part of the national vocabulary.

A half-century has brought marked change to the art and science of poison control. The UPCC has evolved during that time from a modest operation housed in the old Salt Lake County General Hospital into a stand-alone, modern poison control center in the University of Utah's Research Park. It's gone from fielding four calls a day to answering 145 queries daily-more than 53,000 last year.

"The needs for our services changed, and we've adapted to meet those needs," said Barbara Insley Crouch, Pharm. D., M.S.P.H., UPCC director and professor of pharmacotherapy at the University of Utah College of Pharmacy. "We've grown from a small, professional service into a large, public one."

In its early years, the UPCC acted primarily as a service for physicians seeking advice about potential poisonings. Today, the center, part of the College of Pharmacy, works mostly with the public to answer calls about possible poisoning exposures and to educate people about poison control. The center still provides clinical toxicology consultation to clinicians throughout the state.

In recent years, for example, the UPCC:

--Partnered with Smith's grocery stores to collect mercury thermometers-now considered poison threats, themselves, if they become broken-in exchange for safer, digital ones.

--Began tracking calls for symptoms and trends that would indicate whether a chemical or biological agent has been released into the atmosphere.

--Joined a national network of more than 60 poison control centers nationwide tied to one phone number-1-800-222-1222-which connects callers to their nearest poison control center.

--In the summer of 2000, introduced a new Web site, www.uuhsc.utah.edu/poison, with poison prevention tips, links to other educational sites, and information about the UPCC.

--Provided poison prevention education to all health districts in Utah through their "Train-the-Trainer" program.

Amid the changes, large and small, one constant has remained, according to E. Martin Caravati, M.D., M.P.H., UPCC medical director and professor of surgery in the Division of Emergency Medicine at the U School of Medicine: Most poison threats involve children under 6 years old getting into common household items, such as cosmetics, over-the-counter medications, and cleaning products.

"The greatest poisoning threat to children is still found in their own homes," Caravati said. "That's something we're continually trying to educate parents about."

Utahns call the UPCC at twice the national average. Crouch and Caravati cite two reasons for this: a public that is educated about where to call during a poison emergency and the high percentage of Utah families with small children.

Through the years, UPCC has answered emergencies ranging from a teen's near overdose on hallucinogenic jimson weed to identifying the chemicals that killed workers in an industrial accident. Occasionally, today, a toddler will press the speed-dial button on a home phone and the center will get a call. Once in a while, callers have a beastly problem when a dog or other pet ingests a potentially dangerous substance and the owner doesn't know where else to find information. In those cases, UPCC specialists do their best to help the caller or refer them to the national veterinary poison center if they need further help.

The center started keeping statistics and tracking calls in 1971. The number was a comparatively modest 1,500, or about four calls a day, that year. Three years later, the number had increased eightfold to 12,000, or about 32 calls a day. Last year, UPCC staff responded to more than 53,000 calls.

"Anyone who calls the UPCC can know they're being helped by a professional who is specially trained in toxicology," Crouch said.

Registered pharmacists, nurses, and physicians staff the center round-the-clock, every day of the year. The UPCC was founded by pediatrician Alan K. Done, M.D., a member of the U medical school faculty. Initially, the center operated in the Salt Lake County General Hospital Emergency Department, and Done would consult with staff about poison emergencies as needed. When the new University of Utah Hospital opened in 1965, the poison center moved to the U campus and has remained there since then.

Anthony R. Temple, M.D., another medical school faculty member who'd joined the poison center staff in 1966, took over as director in 1971, when Done left to work for the U.S. Food and Drug Administration. Temple pioneered the concept of a regional poison control center, and the facility's name was changed to reflect that--Intermountain Regional Poison Control Center.

The College of Pharmacy's involvement with UPCC started in the late 1960s when David George, Ph.D., a graduate student in pharmacology attended a lecture by Done and became interested in the area of poisoning.

In 1970, Ewart A. Swinyard, Ph.D., pharmacy dean, embraced the idea of a poison center as a training site for pharmacy students who would answer calls. George assumed responsibility for coordinating pharmacy students' work with the center and became associate director. The center now operates under the Department of Pharmacotherapy in the College of Pharmacy.

In addition to the national accreditation status of the center, the UPCC continues to be a training ground for students in the health professions. Each year, the UPCC staff train more than 20 pharmacy and medical students, as well as medical residents in emergency and pediatric emergency medicine.

Various agencies, including the Public Health Service, Medicaid, Utah Department of Health, U School of Medicine, College of Pharmacy, and University Hospital, have funded the center over the years. But a stable funding source had been hard to come by until 1998, when the Utah Legislature approved a 7-cent surcharge on all phone lines in the state, with the revenue going to the UPCC.

In 1993, the center's administrative offices and hotline moved to Research Park, and in 2003, the UPCC moved to newer, roomier quarters also in Research Park.

With a half-century of history to build on, Crouch and Caravati are mindful of the past-and ready for the future.

"In a world of ever-changing chemicals, drugs, and poisons, we remain committed to providing personalized expert advice to the public and health professionals 24 hours a day," Caravati said.